| Entity Name: | BASHAR LUTFI MD PA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Jun 2007 (18 years ago) |
| Last Event: | AMENDMENT AND NAME CHANGE |
| Event Date Filed: | 03 Dec 2021 (3 years ago) |
| Document Number: | P07000068311 |
| FEI/EIN Number | 260341143 |
| Address: | 1725 N UNIVERSITY DRIVE, SUITE 425, CORAL SPRINGS, FL, 33071 |
| Mail Address: | 9397 SATINLEAF PL, PARKLAND, FL, 33076 |
| ZIP code: | 33071 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740458371 | 2008-02-17 | 2021-11-24 | 9397 SATINLEAF PL, PARKLAND, FL, 330763960, US | 1725 N UNIVERSITY DR STE 425, CORAL SPRINGS, FL, 330716000, US | |||||||||||||||||||||||||
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| Phone | +1 305-259-0092 |
| Fax | 7865457627 |
Authorized person
| Name | BASHAR LUTFI |
| Role | PRESIDENT |
| Phone | 9547560615 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | ME 79552 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | AJ151 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AR ACOUNTING & TAX SERVICES | Agent | 5497 WILES RD,, Coconut Creek, FL, 33073 |
| Name | Role | Address |
|---|---|---|
| LUTFI BASHAR | President | 8100 ROYAL PALM BLVD, SUITE 106, CORAL SPRINGS, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-12-03 | 1725 N UNIVERSITY DRIVE, SUITE 425, CORAL SPRINGS, FL 33071 | No data |
| AMENDMENT AND NAME CHANGE | 2021-12-03 | BASHAR LUTFI MD PA | No data |
| CHANGE OF MAILING ADDRESS | 2021-12-03 | 1725 N UNIVERSITY DRIVE, SUITE 425, CORAL SPRINGS, FL 33071 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-04-21 | 5497 WILES RD,, Suite 202, Coconut Creek, FL 33073 | No data |
| REINSTATEMENT | 2011-05-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2011-05-05 | AR ACOUNTING & TAX SERVICES | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-18 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-21 |
| Amendment and Name Change | 2021-12-03 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-09 |
| ANNUAL REPORT | 2019-04-19 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-25 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
